ANTIONETTA HARRIS (NPI# 1689962052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689962052 |
| Entity Type | Individual |
| Full Name | ANTIONETTA HARRIS |
| Credential | CADC |
| Practice Address |
4740 N Clark St Chicago IL 60640-4689 |
| Practice Telephone | 7737690205 |
| Practice Fax Number | 7737650842 |
| Mailing Telephone | 7737690205 |
| Mailing Fax Number | 7737650842 |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-07-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
13390 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE SHIELD | 1616824 | 01 |
| Street Address |
4740 N CLARK ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60640-4689 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861411357 | Todd Frederick Harrison | Social Worker | 4740 N Clark St, C/o C4, Chicago, IL 60640-4689 | 2006-07-18 |
| 1972141950 | Alison Dowd | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2019-12-20 |
| 1275007486 | Teri Cicurel | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2019-01-22 |
| 1609346410 | Chantal Pico | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2018-12-05 |
| 1023595683 | Michelle L Johnson | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2018-07-25 |
| 1649770827 | Judith D Russell | Registered Nurse | 4740 N Clark St, Chicago, IL 60640-4689 | 2018-02-14 |
| 1871009167 | Andrea Vernon-cwik | Social Worker | 4740 N Clark St, Chicago, IL 60640-4689 | 2017-12-21 |
| 1790290385 | Anna Lyman | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2017-12-05 |
| 1639540974 | John Vizuete | Social Worker | 4740 N Clark St, Chicago, IL 60640-4689 | 2015-10-13 |
| 1063888618 | Monica Sade Mitchell | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2015-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1548871916 | Borici Counseling LLC | Counselor | 4731 N Paulina St, Chicago, IL 60640 | 2020-08-11 |
| 1306319173 | Gerardo Garcia | Physician Assistant | Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 | 2019-01-04 |
| 1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
| 1023503885 | Lauren Vassiliades | Internal Medicine | Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 | 2018-06-25 |
| 1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
| 1932622206 | Jasleen Kaur Brar | Internal Medicine | 4646 N. Marine Dr., Chicago, IL 60640 | 2017-07-19 |
| 1750802849 | Umer Mukhtar | Internal Medicine | 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 | 2017-06-29 |
| 1184144081 | Ellie Navidson | Registered Nurse | 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 | 2017-06-21 |
| 1962932558 | Jennifer Stridh | Marriage & Family Therapist | 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 | 2017-06-15 |
| Find all providers in zip 60640 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071932 | Euginia Ivanova | Counselor | 3410 W. Roosevelt Rd, Chicago, IL 60624 | 2020-10-19 |
| 1073127775 | Deborah Lynn Dettman | Counselor | 1209 W Sherwin Ave Apt 809, Chicago, IL 60626-2257 | 2020-09-01 |
| 1538705793 | Andrew W Rintels | Counselor | C/o Madden, Jiganti, Moore & Sinars LLP, 190 South Lasalle Street, Suite 1700, Chicago, IL 60603 | 2019-11-22 |
| 1710528518 | Gateway Professional Services, PC | Counselor | 55 E Jackson Blvd Ste 1500, Chicago, IL 60604-4184 | 2019-10-02 |
| 1801447552 | Erika Chawla | Counselor | 1658 N Milwaukee Ave # 8253, Chicago, IL 60647-6905 | 2019-09-24 |
| 1336790310 | Robert J Smith | Counselor | 2544 W Irving Park Rd Apt 1e, Chicago, IL 60618-3752 | 2019-09-22 |
| 1255997987 | Austin Hall | Counselor | 2942 W Lake St, Chicago, IL 60612-1924 | 2019-05-17 |
| 1417418914 | Monica Connelly | Counselor | 800 N Lake Shore Dr Ste 800, Chicago, IL 60611-2402 | 2019-03-27 |
| 1336608439 | Columbus Manor | Counselor | 5107 W Jackson Blvd, Chicago, IL 60644-4316 | 2019-03-18 |
| 1972062958 | Patricia B Flaherty | Counselor | 210 S Desplaines St Apt 1407, Chicago, IL 60661-5570 | 2019-03-18 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.